Understanding Female Partners of Bisexual Men: Implications for HIV/STD Risk

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DESCRIPTION (provided by applicant): In the United States, the reported rates of new HIV diagnoses among black and Hispanic women are, respectively, 20 and 5.4 times that of white women. A greater tendency toward bisexual behavior and non-gay identification among black and Hispanic men who have sex with men (MSM) than among white MSM is thought to contribute to the large racial/ethnic disparities in HIV/AIDS observed among women; however, nearly nothing is known about the female partners of behaviorally bisexual men. Furthermore, many HIV-infected women are considered "heterosexual unidentified risk" because they do not fit into an HIV transmission category other than sex with a male of unidentified risk. We propose a two-phase study to better understand HIV risk among women of color by identifying predictors of sex with bisexual and unidentified risk men and exploring psychosocial issues surrounding and correlates of these sexual partnerships. This research will be carried out among African-American and Latina females recently tested for HIV in publicly funded test sites in Los Angeles County. In Phase I, a matched case-control analysis will be carried out using secondary data to identify predictors of having had sex with a bisexual man or of being diagnosed HIV-antibody positive with unidentified heterosexual risk. In Phase II, recently tested women will be recruited and interviewed, including 30 who report bisexual male partners and 20 HIV-infected women with unidentified sexual risk. The in-depth semi-structured interview will examine psychosocial factors surrounding sexual relationships with men, including known bisexual, potentially bisexual, and presumed heterosexual men and explore (1) the range of relationship types characterizing women's relationships with these men; (2) attitudes regarding gender roles and desired partner traits; (3) how and when participants became aware of their partners' bisexual behavior and how this awareness influenced their HIV risk perception; (4) how HIV-antibody positive women with unidentified sexual risk perceive they and their partners were infected; and (5) participant's attitudes and behaviors regarding health-related research, health care, and STD/HIV prevention. Interview transcripts will be analyzed using a consensual qualitative research approach to identify major themes and generate hypotheses and survey items for a larger quantitative interview study comparing women reporting sex with a bisexual male to women who do not believe that they have had sex with a bisexual man. They will also help direct prevention resources and guide HIV prevention intervention approaches among women of color.